Ulcerative colitis, also called colitis or proctitis, is an inflammatory bowel disease of the large intestines. Although inflammation usually occurs in the rectum and lower part of the colon, it may affect the entire colon. Unlike Crohn's disease, ulcerative colitis is limited to the colon.
It is estimated that as many as one million Americans are affected with colitis or Crohn's disease. Most cases of colitis are diagnosed before the age of 30, although it can affect anyone, including children and older people between the ages of 50 and 70. There is a greater incidence of the disease among Caucasians and Jews than in other populations.
The condition can be inherited and is common in some families. About 20 percent to 25 percent of those with ulcerative colitis have a close relative with the condition or Crohn's disease. The immune system's response to certain environmental antigens and the patient's own genetic makeup, are believed to be the primary factors causing disease.
Commonly, the first symptom of colitis is a progressive loosening of stool, or diarrhea. The stool may be bloody and may occur with abdominal pain, cramps and a severe urgency to have a bowel movement. Skin lesions and pain in the joints also may occur. Colitis can be associated with problems such as:
Your doctor will ask about your medical history and perform a physical examination. Stool tests will then be performed to determine what is causing your diarrhea — colitis or something else. You will then undergo either a sigmoidoscopy or colonoscopy to exam your colon.
For a sigmoidoscopy, the doctor uses a special instrument called a colonoscope, which is a long, flexible tube that is about as thick as your index finger and has a tiny video camera and light on the end, to exam your rectum and lower part of your colon. During the procedure, everything will be done to help you be as comfortable as possible. Your blood pressure, pulse and the oxygen level in your blood will be carefully monitored.
Currently, the only cure for colitis is surgery. However, treatments are available that can relieve symptoms and suppress the inflammatory process. Therapy varies depending on the seriousness of the disease. Most people will require long-term medication. In severe cases or if cancer is found, surgery may be required to remove the diseased colon.
Drug therapy aims to improve the quality of life for people with colitis by inducing and maintaining remission, or symptom-free periods. There are three types of drugs most commonly prescribed to treat colitis. These include aminosalicylates, corticosteroids and immunomodulatory medicines.
Reviewed by health care specialists at UCSF Medical Center.